Exam 3 Health and Illness 2

Children with a diagnosis of disruptive mood dysregulation disorder have temper tantrums at least how many times per week?

3

When is the typical onset of persistent depressive disorder?

teenage years

What are the physical symptoms that may be present in premenstrual dysphoric disorder?

bloating, overeating, aching, sleep disturbances, breast tenderness

What are some medications associated with depressive symptoms?

antidepressants, antiviral agents, immunological agents, anticonvulsants, cardiovascular drugs

Can individuals have seasonal depressive disorder in the summer?

yes

Depressive disorder due to another medical condition may be caused by disorders that affect the body's systems or from long-term illnesses that cause ongoing pain. There are clear associations, along with ___________________, with some disease states.

neuroanatomical changes

Which are considered adverse childhood experiences?

neglect, substance use in the home, abuse, witnessing spousal abuse, mental illness in the home

Is there a specific gene directly related to the development of depression?

No

Neurotransmitter abnormalities associated with clinical depression can be the result of:

environmental factors

Stressful life events, especially __________, seem to be significant factor in the development of depression

loss

About how many individual with major depression have elevated inflammatory biomarkers in the absence of physical illness?

1/3

The responses and actions of the dying child are affected by:

behaviors and feelings of those around them

What is nearing death awareness?

behaviors such as giving specifics as to when they will see or be with other deceased individuals

which statements are true regarding the child's response to death and dying?

the child may need to know that loved ones will remember them always.

Caregivers may need to give the child "permission" to die

The child may need to know loved ones who are left behind will grieve

Which statement is true regarding a parent's anticipatory grieving related to a child's illness and possible death?

acceptance does not always occur

The grief of the child's grandparents can be greater than that of their own parents because they grieve the loss of their grandchild and also grieve for their own child, the parent who has experienced the death of a child.

true

Which statement is true regarding how siblings cope with death and dying?

the emotions experienced by siblings are different from those of their parents

agonal breaths are painful

false

as family members prepare to hold the deceased child, the nurse discusses the physical changed that occur very quickly after death including:

cooling of the body, stiffening, cyanosis or paleness

the presence of inflammation always means infection is present

false

a nurse reads in the history and physical written by the provider that the wound is healing by secondary intention. Which best described what the nurse will see when assessing the wound?

non-approximated wound edges and granulation tissue

a basic principle of wound management for all open wounds is to:

protect new granulation and epithelial tissue

what are three risk factors for pressure injury formation?

immobility, skin moisture, altered sensory perception

A client has a wound that is profusely bleeding. What is the priority nursing intervention?

hold pressure on the wound

Which patient has the greatest risk for experiencing delayed wound healing?

A client with diabetes and smokes a pack of cigarettes a day

The client who is on post operative day one calls out complaining of pain at the incision site. The nurse assesses the site and notices an area of the edges of the incision are no longer approximated. What is the word to describe this finding?

dehiscence

What can be delegated to the LPN when it comes to wound care?

give oral pain medication for pain and perform subsequent dressing changes for wound

The nurse is planning to assess a wound. Which aspects of the wound need to be documented?

document wound size and depth, describe wound color, describe location of undermining using a clock face, assessment of tissue around the wound

Inflammatory bowel disease encompasses which of the following diseases?

ulcerative colitis and crohn's disease

A family member approaches the nurse about possible causes of inflammatory bowel disease for the client. Which are possible causes or triggers of inflammatory bowel disease?

genetics, infections, use of oral contraceptives

A client with inflammatory bowel disease is at risk for which complications associated with the disease

skin breakdown in perianal area, malnutrition, dehydration, anemia

What should a healthy stoma look like?

brick red

A 25-year-old client is prescribed methotrexate after several acute exacerbations of ulcerative colitis. Which statement by the client determines further education is needed?

"I'm trying to get pregnant"

What aspect of colostomy care cannot be delegated to UAP?

assess skin around stoma

Which of the following best describes the location of the greatest pain in an appendicitis?

midway between the right anterior superior illiac crest and the umbilicus

If the appendix has ruptured and there is evidence of peritonitis or an abscess, giving IV fluids and antibiotic therapy for 6-8 hours before the appendectomy helps prevent dehydration and sepsis

true

Nursing management of peritonitis includes which of the following:

antibiotic therapy, low-intermittent nasogastric suction, antiemetics, analgesics

A nurse may notice which clinical manifestations in a client with an acute appendicitis?

rebound pain, fever, a positive rovsing's sign, nausea, abdominal guarding

Which of the following should be monitored for pediatric client that is associated with inflammatory bowel disease?

Growth, nutritional status, developmental milestones

A charge nurse is reviewing Kubler-Ross: Five Stages of Grief with a group of newly licensed nurses. Which of the following stages should the charge nurse include in the teaching?

denial, bargaining, anger, depression

A nurse is working with a client who has recently lost a guardian. The nurse recognizes that which of the following factors influence a client's grief and coping ability?

interpersonal relationships, culture, religious beliefs, prior experience with loss

A nurse is discussing normal grief with a client who recently lost a child. Which of the following statements made by the client indicated understanding?

"I may experience feelings of resentment"

"I will probably withdraw from others"

"I can expect to experience changes in sleep"

A nurse is caring for a client who lost a guardian to cancer last month. The client states "I'd still have my guardian if the doctor would have made a diagnosis sooner" Which of the following responses should the nurse make?

"You sound angry. Anger is a normal feeling associated with loss"

Which of the following would be considered mourning?

attending a group

A nurse is caring for a client who has major depressive disorder. Which of the following should the nurse identify as a risk factor for depression?

history of chronic bronchitis, recent death in client's family, family history of depression, personal history of panic disorder

The biological approach to treating depression with electrodes surgically implanted into specific areas of the brain to stimulate the regions identified to be underactive in depression is:

deep brain stimulation

When a nurse uses therapeutic communication with a withdrawn client who has major depressive disorder, an effective method of managing the silence is to:

use the technique of making observations

Which nursing intervention focuses on managing a common characteristic of major depressive disorder associated with the older population?

conducting routine suicide screenings at a senior center

Which condition of transient, self-limiting mood disorder that affects new mothers after childbirth?

postpartum blues

A nurse is caring for a client who is experiencing extreme mania due to bipolar disorder. Prior to administration of lithium carbonate, the client's lithium blood level is 1.2 mEq/L. Which of the following actions should the nurse take?

Administer the next dose of lithium carbonate as scheduled

A nurse is admitting a client who has a new diagnosis of bipolar disorder and is schedules to begin lithium therapy. When collecting a medical history from the client's caregiver, which of the following statements is the priority to report to the provider?

"Current medication includes furosemide for congestive heart failure"

A nurse is planning care for a client who has bipolar disorder and is experiencing a manic episode. Which of the following interventions should the nurse include in the plan of care?

offer concise explanations, establish consistent limits, use a firm approach with communication

A nurse is caring for a client who has bipolar disorder. The client states, "I am very rich, and I feel I must give my money to you" Which of the following responses should the nurse make?

"I am here to provide care and cannot accept this money from you"

A nurse is caring for a client with bipolar disorder. Which of the following is the priority nursing action?

monitor the client for escalating behavior

A nurse is caring for a client who state, "I plan to commit suicide." Which of the following assessments should the nurse identify as the priority?

Lethality of the method and availability of means

A nurse is caring for a client who is on suicide precautions. Which of the following interventions should the nurse include in the plan of care?

ensure the client swallows medication

Brain death occurs when all vital organs and body systems cease to function. It is the irreversible cessation of cardiovascular, respiratory, and brain function

false

Death is an irreversible loss of all brain functions, including those of the brainstem. It occurs when the cerebral cortex stop functioning or is irreversibly destroyed.

False

What are the goals of end-of-life care?

provide emotional support to the family

help ensure a dignified death

provide comfort and supportive care during the dying process

improve the quality of the patient's remaining life

As death approached, metabolism increases and the body gradually speeds up until all functions end.

False

What are some psychosocial manifestations at the end of life?

anxiety about unfinished business

denial

peacefulness

life review

worry about burdening others

what are the possible psychologic and physiologic responses to grief?

guilt

despair

sleep problems

illness

how should a nurse respond to anger from either the client or their family?

encourage the expression of feelings

Early-onset bipolar is associated with high rates of what?

suicide attempts

if an individual has cyclothymic disorder, what is the risk they will develop bipolar I or bipolar II disorder?

15%-50%

What comorbidities are associated with bipolar disorders?

conduct disorder

substance use disorder

ADHD

migraines

metabolic syndrome

rapid cycling may include at least two mood episodes in a 12 month period

false

Which of the following factors complicate the clinical picture of bipolar disorders and contribute to treatment delay?

denial of seriousness of disease

minimizing the destructive consequences of their behavior

self medicating through alcohol or substances

reluctance to give up the increased energy, euphoria, and heightened sense of self-esteem

Does repetitive transcranial magnetic stimulation (rTMS) have FDA approval for use in Bipolar depression?

No

How often do we lose a life to suicide?

every 11 minutes

Is non-suicidal self injury an official diagnosis of the DSM-V?

No

Which comorbidities place the patient at higher risk for suicide?

anxiety

substance use

personality disorders

psychosis

MDD

For every suicide, approximately how many survivors are left?

60

A nurse is caring for a patient who has a pressure injury that is treated with debridement, irrigations, and moist gauze dressings. How would the nurse expect healing to occur?

secondary intention

What is the significance of documenting skin assessment findings?

it provides a record for future assessments

The nurse assessing a patient with a chronic leg wound finds redness and edema. The patient reports pain at the wound site. What would the nurse expect to be ordered to assess the patient's systemic response?

WBC count and differential

A basic principle of wound management for all open wounds is for:

protect epithelial and new granulation tissue

When documenting on a wound, which of the following should be included in the documentation?

location of the wound

depth of the wound

description of exudate

The nurse cares for a patient with a clean wound that has formed granulation tissue. Which intervention would be the most appropriate for this patient?

keep tissue moist with a transparent film dressing

Which patients are at most risk for pressure injuries?

a patient with right sided-paralysis and fecal incontinence

a young adult patient with paraplegia after a gunshot wound

a patient with chronic health problems and mobility issues

Which are potential causes of inflammatory bowel disease?

genetics

stress

oral contraceptives

antibiotics

diet low in dietary fiber

The nurse is educating the patient on good food choices after an exacerbation of ulcerative colitis. Which food choice would be the best?

chicken and wild rice soup

A client is having an acute exacerbation of inflammatory bowel disease. Which medications would you expect to be ordered?

corticosteroids

acetaminophen

5-aminosalicylic acid

In planning care for the patient with Crohn's disease, the nurse recognizes that a major difference between ulcerative colitis and crohn's disease is that crohn's disease?

often recurs after surgery, while ulcerative colitis is curable with a colectomy

A patient, who has a colostomy, asks what type of foods they should avoid to decrease odorous gas. You would tell the patient to avoid:

onion, cabbage, broccoli, and eggs

Assessment findings suggestive of peritonitis include

abdominal pain

rebound tenderness

tachycardia

What should a patient be taught after an appendectomy?

start with clear liquid diet

resume normal activities in 2-3 weeks

sign and symptoms of infection

Decreased _______ and _________ of the alveoli and increased alveolar gas pressure can lead to ventilation perfusion mismatch.

perfusion and ventilation

Which of the following are tigger of asthma?

perfumes, dust mites, stress, NSAIDs

What information should the nurse teach families with known triggers of pollen and dust about reducing exposure to pollens and dust?

hypoallergenic covers on pillows and mattresses, stay inside of high pollen count days, use central air conditioning, replace carpet with tile

The nurse is assessing a patient with asthma, priority assessments for asthma includes?

lung auscultation

work of breathing

continuous pulse oximetry

Allergic rhinitis puts clients more at risk for asthma

true

What should the nurse teach a child about using an albuterol metered-dose inhaler for exercise-induced asthma?

Use inhaler 30 minutes before exercise

RSV infection can occur at any age, but with clients at most risk for complications are infants younger than six months of age and older adults

true

A nurse is caring for a client with bronchiolitis due to respiratory syncytial virus (RSV). What is the priority nursing action to reduce the risk of spreading the virus?

move the client to a private room and implement contact precautions.

What are signs of respiratory distress in a child?

grunting, tachypnea, nasal flaring, circumoral cyanosis

Which of the following should be included in a plan of care for a client with bronchiolitis due to respiratory syncytial virus (RSV)?

obtain vital signs and respiratory status every 1-2 hours or more often as needed

FVC (Forced vital capacity)

amount of air that can be quickly and forcefully exhaled after maximum inspiration

Residual volume (RV)

amount of air remaining in lungs after forced expiration. Air available in lungs for gas exchange between breaths

Hypoxia

not enough oxygen available in the tissues to maintain adequate homeostasis